Introduction: Textbooks and pharmacopoeias state that Bai Shao (Paeoniae Radix Alba) nourishes the blood, regulates menstruation, astringes yin, stops sweating, softens the liver, alleviates pain, and is used to treat various symptoms of blood deficiency. However, Mr. Li Jinyong discovered that this differs from the content recorded in the Shennong Bencao Jing. Mr. Li believes that Bai Shao is a laxative rather than a tonic. Let’s take a look at the article!
Bai Shao, historically known as “Shao Yao”.
The Shennong Bencao Jing Volume Two clearly states that it “eliminates blood stasis,” “breaks up hard masses,” and “facilitates urination,” indicating that Bai Shao is undoubtedly a laxative rather than a tonic. Therefore, in the Shang Han Lun and Jin Kui Yao Lue, for abdominal pain, Bai Shao is often added to treat it, as it eliminates stasis and opens the blood vessels to relieve pain.
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Xiao Qing Long Tang (Minor Blue Dragon Decoction) is originally a formula for inducing sweating and expelling fluids. After taking it, if urination is also facilitated, it is due to the effect of Bai Shao.
In Fu Zi Tang (Aconite Decoction) and Zhen Wu Tang (True Warrior Decoction), Bai Shao is used specifically to facilitate urination, allowing Fu Zi to exert its therapeutic effect while its toxicity is eliminated through urination, preventing harm to the body.
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Bai Shao also has the effect of facilitating bowel movements, hence its use in Ma Ren Wan (Hemp Seed Pill) in the Shang Han Lun.
The Shang Han Lun: Differentiating Tai Yin Disease Pulse Patterns and Treatments states: “In cases of Tai Yang disease, if the physician mistakenly purges, resulting in abdominal fullness and pain, it belongs to Tai Yin. Gui Zhi Jia Bai Shao Tang (Cinnamon Twig Decoction with Bai Shao) is the main treatment; for severe pain, Gui Zhi Jia Da Huang Tang (Cinnamon Twig Decoction with Rhubarb) is the main treatment.”
This indicates that in Tai Yang disease, if purging is mistakenly applied and the exterior condition has not been resolved, the pathogen can penetrate internally, causing obstruction and pain. The manifestations of obstruction and pain can be “abdominal fullness with pain” or “severe pain,” indicating the severity of internal obstruction, hence the use of “Bai Shao” and “Da Huang” respectively.
Bai Shao and Da Huang are both classified as laxatives, differing only in their potency.
The aforementioned text from the same chapter of the Shang Han Lun states, “In cases of Tai Yang disease, if the pulse is weak and the person continues to have normal bowel movements, if Da Huang and Bai Shao are to be used, they should be reduced, as the person’s stomach qi is weak and easily disturbed.”
However, due to Bai Shao’s potential to facilitate bowel movements and disturb the stomach, in the Shang Han Lun, for cases of diarrhea, it is often omitted. In the Zhen Wu Tang formula, if diarrhea is present, Bai Shao is removed and dried ginger is added, which is an example.
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As for the cases in the Shang Han Lun where Bai Shao is used despite diarrhea, in the Shang Han Lun: Shao Yin Disease Chapter, there is the Si Ni San (Frigid Extremities Powder) syndrome, where “the diarrhea is heavy and unrelenting,” indicating a desire to relieve but not being able to, due to qi stagnation, hence Bai Shao is used to facilitate.
Moreover, Huang Qin Tang (Scutellaria Decoction) and Ma Huang Sheng Ma Tang (Ephedra and Cimicifuga Decoction) use Bai Shao to treat diarrhea, the former being a Shao Yang disease formula and the latter a Jue Yin disease formula, both of which should also be classified as “heavy and unrelenting diarrhea,” indicating a desire to relieve but not being able to, which the Shang Han Lun does not explicitly mention, but is implied.
As the Jue Yin Disease Chapter states: “For diarrhea, if there is a desire to drink water, it is due to heat; Bai Tou Weng Tang (Pulsatilla Decoction) is the main treatment; for diarrhea with delirium, it is due to dry stool, and Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is indicated.”
The Bai Tou Weng Tang syndrome is for blood-heat dysentery; the Xiao Cheng Qi Tang syndrome is suspected to be what later generations refer to as “strange persistent dysentery,” both of which omit the term “heavy diarrhea.”
Ma Huang Sheng Ma Tang is rarely used today, while Huang Qin Tang is currently used to treat dysentery with pus and blood, and urgency with heaviness. The Bai Shao Tang used in later generations for dysentery, with Bai Shao as the monarch herb, is precisely to take advantage of its laxative effect.
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If one claims that Bai Shao’s function is to astringe yin and nourish blood, one must ask why Bai Shao is used in formulas such as Fu Zi Tang, Zhen Wu Tang, and Da Chai Hu Tang, as well as in Jin Kui Yao Lue formulas like Gan Sui Ban Xia Tang and Wu Tou Tang?
Only when used in conjunction with tonics can it achieve a nourishing effect, hence it is used in the Zhen Ren Yang Zang Tang (True Man’s Nourishing the Organs Decoction) for treating slippery diarrhea and rectal prolapse.
Note: This article is excerpted from the Clinical Series Learning from Famous Teachers – Li Jinyong, authored by Ban Xiuwen, published by China Medical Science and Technology Press in June 2010. This public account is used solely for academic exchange; if there is any infringement, please contact for deletion, and please indicate the source when reprinting.
The cover image is sourced from Baidu Images.